The upside down world of medical tourism

The medical tourism market is ever changing, and consumers are looking for more than just the cheapest treatment. Ian Youngman examines what is really going on with medical tourism in 2016.

Even today, you can read articles by people who have recently discovered medical tourism, carefully explaining that it is price dominated and that all you have to do as an agency or hospital is to target the millions of Americans desperate for cheap care. And they will say that India gets millions of medical tourists, while insurers offer huge medical tourism potential. Writers who have done a bit more research note that the big new potential is from China and Russia, plus increased numbers from the EU Cross Border Directive.

In the real world of medical tourism in 2016, all of this is upside down and back to front.

Looking but not booking

A recent advert for an Asian medical tourism agency site caught my attention. It boasted that it has built a website with lots of information on destinations, then admitted that while thousands had visited, neither patients nor hospitals were prepared to part with cash for that information or advertising as people had just looked but not booked - and they hoped to sell the site to get money back.

Recent changes of where people go and how they book, have seen agencies and information websites crash and burn, while state or country attempts to promote medical tourism more often than not spend more money than they bring in.

There are exceptions, but those promoting medical tourism are learning that they have to have new ideas and constant promotion. Some use advertising and marketing specialists that understand the product and market, but others leave a great deal to be desired. Thailand’s latest slogan of “Visit Thailand Enhance Your Healthy Life” is uninspiring and looks like something produced by a committee. Saving their blushes, other slogans and campaigns, look as if they were produced as an exercise by a student doomed to fail his/her marketing degree.

Winners and losers

The USA is the brightest new star in inbound and domestic tourism, with the combined numbers being several times the numbers and spend of outbound.

Russian outbound medical tourism has imploded, and even if Russia and Turkey have apparently suddenly become best friends, getting Russians to go anywhere for medical tourism, let alone Turkey, is an uphill struggle.

China has huge potential but a large proportion of the numbers is connected to cancer care and birth tourism. Seeking to attract Chinese medical tourists by offering cheap prices is a lost cause. The Chinese want specific treatment, high quality care, high quality comfort and doctors who speak Chinese.

There's a steady flow of state funded medical tourism customers from Gulf States, says conventional wisdom. But as oil revenues change from a gush to a trickle, all Arab states are reducing what they pay for, bringing in compulsory health insurance that forces people to have local treatment, introducing their own inbound medical tourism programmes, and beginning to restrict state paid overseas care .The process is at the beginning as the picture of the booming Gulf fractures.

India is struggling to get above a quarter of million medical tourists, and making slow progress; promises of changes to medical visas made many months ago are still promises, and the much vaunted committee to promote the sector last met in January. The latest laws on surrogacy will kill off one of the most lucrative sectors of medical tourism.

Quality not cost

Every other article on medical tourism bangs on about saving lots of money if you travel abroad, but the countries making money out of medical tourism are often the most expensive. Even South Korea has grasped that increased numbers do not automatically mean more revenue, and is promoting quality.

Nigeria and Zimbabwe are leading the charge of African countries that want to reduce outbound medical tourism and would ban it if they could.

Medical comparison and information websites are making domestic medical tourism in the UK, US and Asia much easier as people can find local affordable treatment, and this will spread across Europe.

Insurance companies see little benefit to them in using medical tourism. Yes they are huge spenders of money for treatment overseas, but almost all of this is for holiday and business travellers and expatriates. A recent study suggested that as many as one in four holiday travellers gets ill or injured on holiday; and in some countries a holiday maker getting pills or medicine from an outpatient clinic or hospital pharmacy suddenly becomes an international patient that in the hospital and country figures is magically transformed into a medical tourist.

I have left the damp squib of EU cross border healthcare to last. Numbers are said to be increasing but other concerns and worries mean that most EU states are doing little more than paying lip service to the Directive. Some countries using it are just doing what they have done, sending people to other cheaper countries, but now doing it under the cross- border directive banner.

Medical tourism is great at filling in the gaps that local healthcare cannot deliver, and many of those gaps are being filled by state, local or international provision.

Medical tourism is filling new gaps, but whether it will ever reach the heady heights that were promised is doubtful.